くも膜下出血の病態におけるspreading depolarizationの意義

Spreading Depolarization After Aneurysmal Subarachnoid Hemorrhage

Point

・SD（spreading depolarization）はくも膜下出血の病態に関与する．

・SDはdelayed cerebral ischemiaのバイオマーカーとして有用である．

・SDに対する治療法の開発は今後の課題である．

　Aneurysmal subarachnoid hemorrhage（aSAH）is a critical condition that often results in severe neurological deficits. Recent studies have highlighted the role of spreading depolarization（SD）in post-aSAH secondary brain injury. SD comprises rapid and sequential changes in neuronal and glial membrane potentials that disrupt energy metabolism and induce neuronal dysfunction. Implicated in both early brain injury（EBI）and delayed cerebral ischemia（DCI）, SD worsens clinical outcomes. This review explores the SD-associated mechanisms in aSAH, ascertains the contribution of SD to EBI and DCI, and identifies potential SD-targeted therapeutic strategies to improve the prognosis of aSAH.